Parents: What You Need to Know About Ear Tubes

Posted on 21 Feb 2017

This content has been clinically reviewed by James Thomsen, MD. 

Your child is tugging on his ear—again. “My ear hurts, Mommy.”

As a parent, you’re definitely not alone. Ear infections are the most common reason parents bring their kids to the doctor, and most kids have at least one middle ear infection by their third birthday. Thankfully, a typical ear infection is not serious, and easily treatable with antibiotics.

Some children, however, have chronic middle ear infections (known as otitis media or OM) that don’t clear up easily and lead to other problems like temporary hearing loss.

When this occurs, your child's doctor may refer you to a pediatric ear, nose and throat (ENT) specialist who may suggest surgery to place tiny tubes in the eardrums to help prevent future ear infections.

You may hear the word “surgery” and say: Surgery on my baby? No way!

Don’t worry. Ear tube surgery is a safe procedure with a very low risk of serious complications. More than half a million kids get ear tube surgery every year—usually when they’re 1 to 3 years old—making it the most common childhood surgery performed with anesthesia.

Why does my child keep getting ear infections?

Some kids suffer from persistent middle ear infections because of environmental factors, like group childcare or secondhand smoke exposure (studies have shown that babies who are around smokers have more ear infections). There is also a genetic component to chronic ear infections. 

Whatever the reason, recurrent middle ear infections can be quite painful. And the pressure of fluid on the eardrum can cause temporary hearing loss, which can lead to delays in speech development and learning. 

What are some signs that my child might need ear tubes?

Ear tube surgery, while common, is not the first choice of treatment for middle ear infections. Most ear infections can be treated with antibiotics or will clear up on their own.

Surgery should only be considered if ear infections become a chronic problem. This may be indicated if your child has one or more of the following symptoms:

  • Four or more ear infections in six months
  • Six or more ear infections in a year
  • Long-term bacterial ear infections that don’t improve with antibiotics
  • Uninfected fluid buildup in the middle ear that lasts at least three months and causes hearing loss or speech delays

Ear infections are the most common reason parents bring their kids to the doctor, and most kids have at least one middle ear infection by their third birthday.

What are the benefits of ear tubes?

Inserting ear tubes may:

  • Reduce the risk of future ear infections (80% of children stop getting ear infections after ear tube surgery)
  • Restore hearing loss caused by middle ear infections
  • Improve speech and balance problems
  • Improve behavior, sleep and learning problems caused by chronic ear infections

How do ear tubes work?

Normally, a child’s eustachian tubes—which run from the middle ear to the back of the throat—drain secretions from the middle ear. Swelling or inflammation from a cold or allergy can block them, causing fluid to build up in the inner ear. This fluid can become infected with bacteria or a virus.

Ear tubes keep this passage open and ventilate the ear through the drum, preventing fluid from backing up and getting infected. They also allow air into the ear and help regulate air pressure. 

What happens during surgery?

The procedure only takes 10 or 15 minutes, and most children require general anesthesia. The surgery is typically done on both ears.

For the procedure, a specialized ENT surgeon will insert a tiny metal or plastic tympanostomy tube into the eardrum. The presence of a tiny hole in the eardrum from this tube doesn’t hurt hearing, in fact there is often an immediate improvement in hearing. 

The tubes remain in place for about eight to 15 months or longer. Some tubes fall out on their own while others have to be removed by a surgeon, usually after three years.

What happens after surgery?

Most children can go home within an hour or two after surgery. Kids usually experience little to no pain after the operation, but may be temporarily groggy or have nausea from the anesthesia.

The doctor may give you antibiotic ear drops to administer for a few days after surgery.

Your child should be back to normal activities right way, including bathing and swimming, unless otherwise instructed by your doctor.

While effective in reducing chronic ear infections, ear tubes aren’t always a permanent cure. As many as 20 percent of kids who need ear tubes by the age of 2 may need them again when they’re older.

What are the risks of ear tube surgery?

Ear tube surgery is a relatively safe procedure, but as with any surgery, there are some risks. Possible complications include:

  • Tubes that come out too soon. This could result in the need for additional surgery.
  • Tubes that stay in too long. They may need to be removed by a surgeon.
  • Infection. Ear infections can still occur with a tube in place, however they’re usually more mild.
  • Scarring of eardrum. In most cases this doesn’t cause any problems with hearing and doesn’t need any treatment.
  • Perforation of the ear drum. This is rare and can happen when a tube comes out or is removed and the hole in the eardrum doesn’t close. This requires a surgical procedure to patch the hole.

Surgery usually requires general anesthesia, which carries some risks as well, including:

  • Allergic reaction
  • Breathing difficulties
  • Heart irregularities
  • Nausea or vomiting after the procedure

A specialized pediatric amnesia team is trained to manage these issues.

This content is general information and is not specific medical advice. Always consult with a doctor or healthcare provider if you have any questions or concerns about the health of a child. In case of an urgent concern or emergency, call 911 or go to the nearest emergency department right away. Some physicians and affiliated healthcare professionals on Children’s Healthcare of Atlanta team are independent providers and are not our employees.